BETHANY JOY MUMBOWER Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****12

License Status

ACTIVE

Business

First Name

BETHANY

Middle

JOY

Last Name

MUMBOWER

Business Name

BETHANY JOY MUMBOWER

Original Issue Date

09/01/2010

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62704

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/22/2026